Agencies Issue Proposed Regulations on Summary of Benefits and Coverage Requirement


On August 22, 2011, the Departments of Treasury, Labor, and Health & Human Services (the "Agencies") jointly issued proposed regulations regarding the new Summary of Benefits and Coverage ("SBC") required by the Patient Protection and Affordable Care Act of 2010 (the "ACA"). Under the proposed regulations, on March 23, 2012, insurers and employers that provide group health coverage, including sponsors of grandfathered plans, must begin providing SBCs in accordance with the proposed rules.

The proposed regulations include two general requirements: (i) group health plan insurers must provide an SBC to a group health plan or the group health plan sponsor, and (ii) group health plan insurers or group health plans must provide an SBC to each participant and beneficiary. In general, employers that provide group health plans to employees will only need to be concerned with the later requirement to deliver SBCs to participants and beneficiaries.

The proposed regulations also provide guidance regarding...

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